In May 1980, investigators reported to CDC 55 cases of toxic-shock syndrome (TSS),1 a newly recognized illness characterized by high fever, sunburn-like rash, desquamation, hypotension, and abnormalities in multiple organ systems.2 Fifty-two (95%) of the reported cases occurred in women; onset of illness occurred during menstruation in 38 (95% ) of the 40 women from whom menstrual history was obtained. National and state-based studies were initiated to determine risk factors for this disease. In addition, CDC established national surveillance to assess the magnitude of illness and follow trends in disease occurrence; 3295 definite cases have been reported since surveillance was established.

In June 1980, a follow-up report described three studies which detected an association between TSS and the use of tampons.3 Case-control studies in Wisconsin and Utah and a national study by CDC indicated that women with TSS were more likely to have used tampons than were controls.